1989 Volume 22 Issue 11 Pages 1195-1200
Polymorphonuclear neutrophil elastase (PMN-E) has been shown to increase during hemodialysis (HD). To determine the factors which influence the increment of PMN-E, 37 hemodialyzed patients were studied. PMN-E levels in plasma obtained before and after HD were measured by enzyme immunoassay. There was no significant difference between the DM Group (n=12) and non-DM Group (n=25), nor was there any significant difference between the short HD duration Group (less than 3 months, n=24) and the long HD duration Group (more than 5 months, n=13).
As far as the dialyzer membrane was concerned, there was no significant difference between 15 patients treated with regenerated cellulose membranes and polymethylmethacrylate (PMMA) membrans. Nor was there any significant difference between 18 patients treated with heparin and FUT-175 (nafamostat mesilate).
When the effects of vitamin D3 (Vit D3) and calcium bicarbonate on PMN-E levels were evaluated, combined use of Vit D3 and calcium bicarbonate seemed to depress the PMN-E elevation rather than use of calcium bicarbonate alone or no usage of these agents at all.
There was no significant correlation between serum calcium levels and PMN-E levels in any of the cases. However, there were strong correlations between elevations in serum calcium and PMN-E in 3 of the cases.
From these results, it appears that alteration of serum calcium levels and certain agents, such as Vit D3 and calcium bicarbonate, might be involved in the mechanism of PMN-E elevation during HD.
